Breath-Holding Spells

Breath holding spells are a common phenomenon in young children, usually occurring between the ages of 6 months and 6 years. They are characterized by a sudden cessation of breathing, usually in response to a perceived threat or frustration. The child may become pale, limp, and unresponsive, and may even lose consciousness. The episode usually lasts for a few seconds to a few minutes, and the child typically recovers quickly and without any lasting effects. Treatment is usually not necessary, but parents should be aware of the signs and symptoms of breath holding spells and should seek medical attention if the episodes become more frequent or severe.

Two types of breath-holding spells

1. Pallid: child turns a pale color

Characteristics include:

  • Triggered by sudden fright pain or falling with a minor injury to the head
  • Child may gasp and give a brief cry
  • It is estimated that around one third of children with breath-holding spells have a family history of similar episodes
  • Child becomes pale, loses consciousness and becomes limp
  • Child may become sweaty and may stiffen and have a few body jerks or lose bladder control
  • Episodes are brief and last less than one minute
  • Child regains consciousness and will recognize people but can seem sleepy

Note: The brain sends out a signal that severely slows the heart rate, causing loss of consciousness.

2. Cyanotic: child turns a blue color, especially around the lips

Characteristics include:

  • Triggered by becoming frustrated or angry 
  • The child may cry vigorously, usually less than 15 seconds 
  • After crying, the child becomes silent, stops breathing. and rapidly turns blue 
  • The child usually loses consciousness, goes limp, or stiffens and arches his back 
  • Recovery happens in less than one minute 
  • May gasp and return to regular breathing 
  • Regain consciousness and returns to normal 
  • May seem tired 
  • It is rare for the child to be upset and cry again triggering another episode.

Signs and symptoms

During a breath-holding spell, a child may:

  • Turn blue or become pale;
  • Lose consciousness;
  • Stop breathing;
  • Have a strained face as if they are crying, although they will make no sound;
  • Become limp;
  • Faint;
  • Sweat;
  • Have muscle twitching or body stiffness;
  • Have jerky movements, and;
  • Cry.


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